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What Do Difficulty Breathing And High ESR Levels Indicate?

Posted on Thu, 29 Oct 2015

Question: Hi I'm concerned about my wife. She lives in XXXXXXX Her ESR level was 69 and she has difficulty breathing when she picks up heavy items or when she climb the stairs. What should I do?

Answered by Dr. Drkaushal85 (6 hours later)

Brief Answer:
Get done CT thorax and PFT.

Detailed Answer:
Thanks for your question on Health Care Magic.
I can understand your wife's situation and problem.
White spots on lung base on chest x ray are seen in
1. Pulmonary fibrosis
2. Bilateral lower zone pneumonia.
3. Bronchitis.
And in all these conditions breathlessness on exertion with high ESR are seen.
So better to consult pulmonologist and get done
1. Clinical examination of respiratory system
2. CT thorax
3. PFT (Pulmonary Function Test).. CT thorax is needed to rule out fibrosis and pneumonia. PFT is must for the diagnosis of bronchitis.
She may need antibiotics, inhaled bronchodilators and inhaled corticosteroid (ICS).
Hope I have solved your query.
I will be happy to help you further.
Wishing good health to your wife. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (17 hours later)

She did a PFT and she was told that her lung capacity was a little low but not to the point she needed to be worried. She thinks she has lung cancer or some serious life threatening issues. She saw a pulmonologist and he insisted that there was nothing to be concerned with. He told her she had a mild case of bronchiectasis. He told he can do a bronchoscopy with lavage and get a sputum sample. Her ESR was initially 44 and he prescribed her clarithromycin 500 mg twice a day for five days. She finished the course and went to repeat the ESR and thats when her result was 69. So the doctor said we needed a sputum sample but she wasn't able to give a sample. So thats when he insisted to do a lavage and bronchoscopy. She is worried that the sample is going to show something serious. I just wanted to know if I needed to be worried after all this. Thanks. Looking forward to your reply.

Also she was diagnosed with dengue fever about two months ago so I didn't know if that had anything to do with her breathing difficulties or her ESR being high.

Answered by Dr. Drkaushal85 (11 hours later)

Brief Answer:
Get done broncoscopy and lavage.

Detailed Answer:
Thanks for your follow up question on HCM.
I can understand your concern.
First of no need to worry for lung cancer.
Her high ESR is mostly due to infection.
She is having mild bronchiectesis.
And infection is very common bronchiectesis. So we need to first isolate the causative organism for infection.
So that we can start appropriate antibiotic treatment.
And for this sputum sample is required. If she is not able to expectorate good quality sputum than bronchoscopy with XXXXXXX (bronchoalveolar lavage) is the only option.
So better to get done lavage for isolation of organism and starting of appropriate antibiotic.
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wishing good health to your wife. Thanks.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj